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      Gender-specific differences in valvular heart disease

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          Summary

          The development of new devices and treatment options has greatly increased the interest in heart valve diseases. In this context, the consideration of gender differences in diagnosis, treatment success, and prognosis is of great importance. Available data show that women and men with heart valve disease have different risk profiles, which have a significant impact on treatment outcomes and prognosis.

          It is the purpose of this review article to give an overview of gender-related differences in patients with valvular heart disease, regarding clinical presentation, treatment, and outcomes. In light of the emerging treatment possibilities, future research should emphasize the role of gender since both sexes benefit from tailored management.

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          A prospective survey of patients with valvular heart disease in Europe: The Euro Heart Survey on Valvular Heart Disease.

          Bernard Iung, Gabriel Baron, Eric G Butchart … (2003)
          To identify the characteristics, treatment, and outcomes of contemporary patients with valvular heart disease (VHD) in Europe, and to examine adherence to guidelines. The Euro Heart Survey on VHD was conducted from April to July 2001 in 92 centres from 25 countries; it included prospectively 5001 adults with moderate to severe native VHD, infective endocarditis, or previous valve intervention. VHD was native in 71.9% of patients and 28.1% had had a previous intervention. Mean age was 64+/-14 years. Degenerative aetiologies were the most frequent in aortic VHD and mitral regurgitation while most cases of mitral stenosis were of rheumatic origin. Coronary angiography was used in 85.2% of patients before intervention. Of the 1269 patients who underwent intervention, prosthetic replacement was performed in 99.0% of aortic VHD, percutaneous dilatation in 33.9% of mitral stenosis, and valve repair in 46.5% of mitral regurgitation; 31.7% of patients had > or =1 associated procedure. Of patients with severe, symptomatic, single VHD, 31.8% did not undergo intervention, most frequently because of comorbidities. In asymptomatic patients, accordance with guidelines ranged between 66.0 and 78.5%. Operative mortality was <5% for single VHD. This survey provides unique contemporary data on characteristics and management of patients with VHD. Adherence to guidelines is globally satisfying as regards investigations and interventions.
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            Prevalence and clinical outcome of mitral-valve prolapse.

            David J. Evans, Joy Larson, Christina Fuller … (1999)
            Mitral-valve prolapse has been described as a common disease with frequent complications. To determine the prevalence of mitral-valve prolapse in the general population, as diagnosed with the use of current two-dimensional echocardiographic criteria, we examined the echocardiograms of 1845 women and 1646 men (mean [+/-SD] age, 54.7+/-10.0 years) who participated in the fifth examination of the offspring cohort of the Framingham Heart Study. Classic mitral-valve prolapse was defined as superior displacement of the mitral leaflets of more than 2 mm during systole and as a maximal leaflet thickness of at least 5 mm during diastasis, and nonclassic prolapse was defined as displacement of more than 2 mm, with a maximal thickness of less than 5 mm. A total of 84 subjects (2.4 percent) had mitral-valve prolapse: 47 (1.3 percent) had classic prolapse, and 37 (1.1 percent) had nonclassic prolapse. Their age and sex distributions were similar to those of the subjects without prolapse. None of the subjects with prolapse had a history of heart failure, one (1.2 percent) had atrial fibrillation, one (1.2 percent) had cerebrovascular disease, and three (3.6 percent) had syncope, as compared with unadjusted prevalences of these findings in the subjects without prolapse of 0.7, 1.7, 1.5, and 3.0 percent, respectively. The frequencies of chest pain, dyspnea, and electrocardiographic abnormalities were similar among subjects with prolapse and those without prolapse. The subjects with prolapse were leaner (P<0.001) and had a greater degree of mitral regurgitation than those without prolapse, but on average the regurgitation was classified as trace or mild. In a community based sample of the population, the prevalence of mitral-valve prolapse was lower than previously reported. The prevalence of adverse sequelae commonly associated with mitral-valve prolapse in studies of patients referred for that diagnosis was also low.
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              Refining the prognostic impact of functional mitral regurgitation in chronic heart failure

              Noemi Pavo, Raphael Wurm, Irene Lang … (2018)
              Significant efforts are currently undertaken to reduce functional mitral regurgitation (FMR) in patients with chronic heart failure in the hope to improve prognosis. We aimed to assess the prognostic impact of FMR in heart failure with reduced ejection fraction (HFrEF) under optimal medical therapy (OMT) and various conditions of HFrEF. We further intended to identify a heart failure phenotype, where FMR is most likely a driving force and not a mere bystander of the disease.
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                Author and article information

                Contributors
                Christian Nitsche: christian.nitsche@meduniwien.ac.at
                Matthias Koschutnik: matthias.koschutnik@meduniwien.ac.at
                Andreas Kammerlander: andreas.kammerlander@meduniwien.ac.at
                Christian Hengstenberg: christian.hengstenberg@meduniwien.ac.at
                Julia Mascherbauer: julia.mascherbauer@meduniwien.ac.at
                Journal
                Journal ID (nlm-ta): Wien Klin Wochenschr
                Journal ID (iso-abbrev): Wien. Klin. Wochenschr
                Title: Wiener Klinische Wochenschrift
                Publisher: Springer Vienna (Vienna )
                ISSN (Print): 0043-5325
                ISSN (Electronic): 1613-7671
                Publication date (Electronic): 29 January 2020
                Publication date PMC-release: 29 January 2020
                Publication date (Print): 2020
                Volume: 132
                Issue: 3
                Pages: 61-68
                Affiliations
                GRID grid.22937.3d, ISNI 0000 0000 9259 8492, Department of Internal Medicine II, , Medical University of Vienna, ; Waehringer Guertel 18–20, 1090 Vienna, Austria
                Article
                Publisher ID: 1603
                DOI: 10.1007/s00508-019-01603-x
                PMC ID: 7035223
                PubMed ID: 31997064
                SO-VID: a10ed33e-f120-4196-8095-ba9ebaf2f4b3
                Copyright © © The Author(s) 2020
                License:

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                Date received : 30 June 2019
                Date accepted : 18 December 2019
                Funding
                Funded by: Medical University of Vienna
                Open Access :

                Open access funding provided by Medical University of Vienna.

                Categories
                Subject: Review Article
                Custom metadata
                issue-copyright-statement © Springer-Verlag GmbH Austria, part of Springer Nature 2020

                ScienceOpen disciplines: Medicine
                Keywords: aortic stenosis,mitral regurgitation,tricuspid regurgitation,sex,women
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: aortic stenosis, mitral regurgitation, tricuspid regurgitation, sex, women

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